Sleep Problems in Critically Ill Patients
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Date
2010-04-09
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Thai Journal of Tuberculosis Chest Diseases and Critical Care
Abstract
Critically ill patients are known to suffer from severely fragmented sleep even if the total sleep time is often less decreased. In addition to severity of diseases itself, the critical care environment is also a harsh one for sleep. Given that the patients usually spend as much time sleeping during the day as at night, the circadian rhythm is also affected accordingly. The severely fragmented sleep is attributed to frequent arousals and awakenings during sleep. The sleep architecture with a predominance of stage I sleep and a paucity of slow wave and REM sleep is often seen in critically ill patients. Several factors are believed to contribute to sleep disruption found in critically ill patients. Basically, noise, patients care, medication, medical illness, and psychological stress from disease have been considered to be important factors. The clinical importance of this type of sleep disruption in critically ill patients, however, is not known. Recently, there has been a lot of evidence demonstrating the role of ventilator itself in disturbing sleep quality and quantity. Additionally, the studies revealed that sleep fragmentation may also influence multiple aspects of a critically ill patientûs course, response to treatment, and ultimate outcome. Accordingly, understanding and prompt treatment of sleep deprivation in critically ill patients may have further improved the treatment effects of conventional treatments.
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Thai Journal of Tuberculosis Chest Diseases and Critical Care; Vol.30 No.2 April-June 2009; 84-93